Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or California for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to California only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. California (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Neighborhood Healthcare (NPI 1598703647)

Field	Value
Entity Type	Organization
Organization	Neighborhood Healthcare
Address	460 N Elm St
City	Escondido
State	CA
ZIP	92025
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 2, 2006

Payer Source	Total Paid
Medicaid	$125M
Medicare	$0

Key Findings

This entity is effectively single-payer by scale: Medicare revenue is listed as none (no Medicare billing on file) while Medicaid revenue totals $125M, indicating the organization’s operations and revenue are overwhelmingly Medicaid-driven rather than balanced across payers. The provider’s NPI was enumerated 2006-06-02 (~20 years ago), consistent with an established FQHC footprint in the market.

Revenue concentration is extreme: the precomputed top 3 Medicaid codes by revenue account for 92.0% of this provider's total Medicaid revenue, dominated by T1015 ($95.6M, 490.1K claims, $195 avg/claim, 76.7% of Medicaid revenue), 00003 ($16.1M, 60.8K claims, $264 avg/claim, 12.9%), and 99213 ($3.1M, 512K claims, $6 avg/claim, 2.5%). This concentration implies that a very small set of bundled clinic-visit and low-level E/M codes drive nearly all Medicaid dollars for the organization.

The code mix and volumes are consistent with a high-volume FQHC primary care model: T1015 (clinic visit/encounter, all-inclusive) is the single biggest revenue driver at $95.6M and G0467 (FQHC visit, established patient) appears on the list with 27.7K claims and $526K revenue, ranking #14 of 1029 in-state (99th percentile; extreme outlier). These patterns indicate the provider operates as a centralized clinic delivering bundled FQHC services rather than relying on complex, high-acuity specialty billing.

Behavioral health is a material service line: 90832 shows 108.5K claims and $2.8M revenue and ranks #1 of 1431 in-state (100th percentile; extreme outlier), while 90834 (19.2K claims, $536.8K) and 90791 (7.4K claims, $439.1K) also rank high (99th percentile). The presence of multiple high-volume psychotherapy and psychiatric evaluation codes at extreme percentile ranks signals an embedded behavioral health program that is a distinctive component of the organization’s service mix.

The provider reports unusually high volumes for several non-primary-care services and care-coordination codes, suggesting broad, integrated offerings: 98941 (71.5K claims, $857.8K) ranks #1 of 494 in-state (100th percentile; extreme outlier) for spinal manipulation, G2025 (telehealth distant site for FQHC) is 11.3K claims and $90.7K revenue ranking #4 of 575 (99th percentile; extreme outlier), and G0511 (general care management) is 8K claims and $64.2K ranking #5 of 183 (98th percentile; extreme outlier). These items point to a care model that combines primary care, allied modalities, telehealth, and care management at scale.

Competitive standing within California Medicaid is dominant on several top codes: T1015 ranks #14 of 1550 providers in-state (99th percentile; extreme outlier) and 99213 ranks #8 of 14524 providers (100th percentile; extreme outlier), indicating this provider is a major statewide participant for core FQHC clinic and low-level E/M volume. By contrast, 00003 (60.8K claims, $16.1M) ranks #76 of 688 (89th percentile) and is described as typical in-state volume, showing that not every high-dollar code is exceptional relative to peers.

Operationally, the combination of extreme claim volumes for low-paid E/M codes and a high-dollar bundled FQHC code suggests reliance on visit throughput and bundled payments: 99213 has 512K claims at $6 avg/claim while T1015 carries $195 avg/claim and drives $95.6M in revenue. This mix implies the provider’s financial performance is sensitive to visit volume and FQHC payment policies rather than higher-margin specialty procedures.

The full code-profile shows both areas of pronounced outlier behavior and more typical activity: multiple codes are labeled extreme outlier or notably above typical state volume (for example 90832, 98941, G0467, and G2025), while other codes such as G9012 ($1.2M, rank #100 of 718, 86th percentile) and 00003 are within more typical ranges. For analysts, this means the organization is a statewide leader on several high-volume FQHC and behavioral health services but remains a standard performer on some adjunct services, which shapes competitive positioning and potential opportunities for targeted payer engagement.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

194 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	490,110	$200	$95.6M
00003	N/A	60,850	$260	$16.1M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	512,020	$10	$3.1M
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	108,470	$30	$2.8M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	113,340	$10	$1.6M
G9012	Other specified case management service not elsewhere classified	8,440	$140	$1.2M
98941	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in three to four spinal regions.	71,480	$10	$857.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	93,750	$10	$562.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	19,170	$30	$536.8K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	27,690	$20	$526K

Showing 1–10 of 194

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.

Claims Volume vs. California Distribution

Neighborhood Healthcare — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

194 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	14	1,550	38,050	$190	$14.1M
00003	N/A	76	690	14,940	$260	$7.7M
G9012	Other specified case management service not elsewhere classified	100	720	1,110	$110	$651.3K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	3,534	4,290	780	$140	$400.1K
G9008	Coordinated care fee, physician coordinated care oversight services	85	490	660	$70	$396.7K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	244	390	250	$200	$220.4K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	14	1,030	1,050	$70	$219.7K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	28	1,950	500	$80	$179K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	46	13,300	640	$40	$169.6K
J3490	Unclassified drugs	1,329	1,390	670	$20	$159.5K

Showing 1–10 of 194

Related Providers

Other providers that share a Tax Identification Number (TIN) with Neighborhood Healthcare, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Neighborhood Healthcare	CA	Federally Qualified Health Center (FQHC)	$0	$160.1M
Neighborhood Healthcare	CA	Federally Qualified Health Center (FQHC)	$0	$46.7M
Neighborhood Healthcare	CA	Federally Qualified Health Center (FQHC)	$0	$38.3M
Neighborhood Healthcare	CA	Federally Qualified Health Center (FQHC)	$0	$33.1M

Nearby Providers

Other providers in the same ZIP code as Neighborhood Healthcare, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dap Health, Inc.	CA	Federally Qualified Health Center (FQHC)	$0	$28.6M
Empower Genomics Corp	CA	Clinical Medical Laboratory	$6.5M	$252.2K
Escondido Ca Endoscopy Asc LP	CA	Ambulatory Surgical Clinic/Center	$499.2K	$5.2M
Amar Amin	CA	Diagnostic Radiology Physician	$3.6M	$6.5K
Joshua Morrison-reyes	CA	Retina Specialist (Ophthalmology) Physician	$2M	$18.2K
Debra Hexom	CA	Family Nurse Practitioner	$1.8M	$0
Philip Bosch	CA	Urology Physician	$1.3M	$230
Mission Treatment Services, Inc.	CA	Methadone Clinic	$167.7K	$683.8K
Veni-express, Inc.	CA	Clinical Medical Laboratory	$487.1K	$221.9K
Jason Morris	CA	Foot & Ankle Surgery Podiatrist	$345.4K	$1.6K

Neighborhood Healthcare — Billing Profile & Reimbursement Data

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Neighborhood Healthcare — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References